title: Deterioration in asthma control when subjects receiving fluticasone propionate/salmeterol 100/50 mcg Diskus are "stepped-down".
abstract: In this study, 647 subjects stable on fluticasone propionate/salmeterol Diskus 100/50 mcg BID (FSC) were randomized to continue FSC 100/50 mcg BID or "step down" to either fluticasone propionate (FP) 100 mcg BID, salmeterol (SAL) 50 mcg BID, or montelukast (MON) 10 mg once daily for 16 weeks. Overall asthma control significantly improved in the FSC group; whereas, "stepping down" to FP, SAL, or MON resulted in deterioration in asthma control, as determined by decreased measures of lung function and clinical features. This study provides support that treatment of both inflammation and smooth muscle dysfunction may be necessary to achieve and maintain asthma control in patients uncontrolled on ICS.
authors.affiliation: University of Virginia, Division of Pulmonary Medicine & Critical Care, Charlottesville, VA 22908, USA. smk4q@virginia.edu
authors.forename: Steven M
authors.initials: SM
authors.lastname: Koenig
authors.forename: Nancy
authors.initials: N
authors.lastname: Ostrom
authors.forename: David
authors.initials: D
authors.lastname: Pearlman
authors.forename: Kelli
authors.initials: K
authors.lastname: Waitkus-Edwards
authors.forename: Steven
authors.initials: S
authors.lastname: Yancey
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Prillaman
authors.forename: Paul
authors.initials: P
authors.lastname: Dorinsky
mesh_terms: D000085:Acetates / Q000008:administration & dosage*; D000420:Albuterol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000730:Androstadienes / Q000008:administration & dosage*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D003521:Cyclopropanes; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D000068298:Fluticasone; D000068297:Fluticasone-Salmeterol Drug Combination; D005540:Forced Expiratory Flow Rates / Q000187:drug effects; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D017060:Patient Satisfaction; D010366:Peak Expiratory Flow Rate / Q000187:drug effects; D011804:Quinolines / Q000008:administration & dosage*; D000068299:Salmeterol Xinafoate; D013440:Sulfides; D011795:Surveys and Questionnaires
chemical_list: D000085:Acetates; D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D003521:Cyclopropanes; D004338:Drug Combinations; D000068297:Fluticasone-Salmeterol Drug Combination; D011804:Quinolines; D013440:Sulfides; D000068299:Salmeterol Xinafoate; D000068298:Fluticasone; C093875:montelukast; D000420:Albuterol